As the COVID-19 outbreak progresses it will become increasingly difficult to conduct in-person hygiene promotion sessions. Since people may have to continue to visit distribution points this is an opportunity to share information at these sites. In these sites we suggest using static and interactive hygiene promotion approaches.
Handwashing on entry and departure - this will help position handwashing as a key preventative behaviour and something that is the new norm within the camp or community distribution point.
Physical distancing cues - make sure you put in place simple cues in the physical environment to encourage people to stand 2m apart. These can be stickers, dots painted on concrete, stones or pieces of wood that are dug into the ground, or circles made from different coloured sand.
Billboards or posters - If people are spread out in a physically distanced line awaiting their kits, then place billboards or posters along the line so that people have something to engage with while they wait. When designing these make sure to use lots of imagery (to overcome potential illiteracy) and keep wording to a minimum and in all locally spoken languages. Posters could cover transmission, symptoms and preventative actions. However, consider other more creative options too. For example you could create a sense of transparency by adding an updatable board with information about cases confirmed, cases being treated, cases recovered in the local area. You could also add information about provisions (e.g. X number of additional hand washing facilities have been constructed or next kit distribution is expected on X date). Alternatively use these posters to convey non-health messages which are encouraging, positive and create a sense of community spirit.
Hygiene promotion whilst people queue for distribution - while people are queuing seize the opportunity to do hygiene promotion activities. This could include explaining the posters or billboards as described above but could also include simple ‘experiment-like’ activities which may have a stronger behavioural impact. For ideas on how to do this see our article on practical actions for handwashing promotion. Combining hygiene promotion with kit distribution was found to be effective in Bangladesh during a cholera outbreak.
Communication materials in kits - Consider adding pamphlets or posters about COVID-19 into kits. These could also cover topics like transmission, symptoms and preventative actions but may also include practical advice about the new situation - e.g. tips for cleaning. When designing these pamphlets make sure they include lots of images. Think about whether they would make sense to someone who is illiterate. If you are including posters, think about how they could be made more decorative so that people are more inclined to display them. An example might be to include a large image of a strong, happy and healthy family and then include a section below with key behaviours that can help keep people healthy.
Make sure physical distancing is maintained when people queue for distribution. Source: Ministry of Health Kenya
Redesign what hygiene promoters wear - Normally humanitarian organisations each wear organisation branded clothing. At this time it may be more important than normal to convey that all organisations are working in a harmonsed manner and are implementing measures which may seem strange but are for everyone’s benefit. Consider producing t-shirts that say something like ‘We are all in this together’ or ‘together we can beat coronavirus’ and have a visual image which depicts this.
Public screens - Consider setting up large TV screens which share messages about COVID-19. While content shown should be educational, it may be more powerful if they also tell a story or appeal to aspirational ideas. For more information on this see our article on what influences hygiene behaviour.
Add in rewards - Practicing hygiene behaviours and physical distancing will not be easy in camp or densely-populated community settings. So it is important to recognise the sacrifices people are making and reward them for doing the right thing. Consider adding small gifts and thank you notes into each hygiene kit. For example this could simply involve wrapping up the additional bars of soap in wrapping paper and adding a bow as if they were a present. Add a gift tag that says something like ‘Thanks for doing the right thing. Keep it up’
Learning from your community - While people are queuing can be a great time for hygiene promoters to speak with members of the population. Develop structured and informal ways to understand current perceptions, answer common questions and get feedback on their programming and what makes things easier. You can prepare your hygiene promoters with a series of frequently asked questions and ideal responses to help them answer questions from the population.
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Editor's note
Author: Sian White
Review: Tom Heath, Lauren D'Mello-Guyett
Last update: 15.04.2020